CQC report explained · a nursing home
What the CQC found at Highfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Safeguarding, risk assessment, staffing, recruitment and medicines systems were found to be suitable. The fire risk assessment was being updated with help from an external specialist.
- Effective?
- Good
- Staff assessed people's health, nutrition and communication needs and worked with health professionals. Training, supervision and support for staff were in place, and consent and best-interest processes were followed.
- Caring?
- Good
- Inspectors saw kind and patient interactions. Staff knew people well, respected privacy and dignity, and supported people to express views and make everyday choices.
- Responsive?
- Good
- Care plans reflected people's preferences and were reviewed. People had access to activities, communication aids and support to maintain relationships. End-of-life wishes were recorded and supported.
- Well-led?
- Good
- Inspectors found positive leadership and quality monitoring. Staff, relatives and health professionals gave positive feedback about management, communication and partnership working.
What inspectors found, October 2019
Bethel House was rated Good in all five areas; inspectors found safe, kind and personalised care.
This was an unannounced planned inspection on 10 September 2019. Inspectors reviewed care, medicines, staffing, training, complaints and quality records. They looked at eight people's care records, checked the building and spoke with people living there, relatives, staff and health professionals.
The inspectors found people were safe and well cared for. Staff knew people's histories and preferences, supported their health and nutrition, and gave medicines safely. People were treated with kindness, dignity and respect. They were supported to make choices, join activities and keep in touch with relatives.
The home was clean and well maintained. Its dementia-friendly environment was being improved, and there were systems for managing complaints and learning from incidents. All five ratings stayed Good, the same as at the previous inspection published in March 2017.
Safeguarding and safety
Staff had safeguarding training and understood how to recognise and report concerns. Risk assessments, emergency plans and equipment checks were in place.
“Staff we spoke with were confident the registered manager would act quickly to keep people safe if they reported any concerns.” from the report
Kind and respectful care
Staff formed positive relationships with people and supported their dignity, privacy and choices.
“We saw staff were kind and compassionate and had formed positive relationships with people and knew them well.” from the report
Dementia-friendly environment
The home had acted on the previous recommendation to make the environment more suitable and stimulating for people living with dementia.
“There was a well-planned approach to developing the environment for people living with dementia.” from the report
Activities and social life
People could choose from organised and informal activities, including social events and themed areas within the home.
“People told us they did not have to participate in any activity if they did not want to.” from the report
Positive leadership
Inspectors found an open management culture. Staff felt supported, and the home used feedback and audits to improve care.
“We found there was a positive management culture within the service.” from the report
Fire risk assessment being updated
minorThe fire risk assessment was being updated with help from an external specialist. The report does not say that this caused harm, but families should check that the update has been completed.
“The registered manager confirmed they were currently updating their fire risk assessment with an external specialist to make sure it was up to date and thorough.” from the report
- 01Has the fire risk assessment now been fully updated, and what changes were made?
- 02How do you review staffing levels when people's needs change, including at night?
- 03How is the new electronic care planning system being introduced, and how will you check that records remain accurate?
- 04How are people and relatives involved in decisions about CCTV in communal areas?
- 05How will you record and review each person's treatment wishes and end-of-life preferences?
This was an unannounced planned inspection that looked at all five CQC questions, including care, medicines, staffing, the building, records and management systems. This explanation was written from the published report of 18 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2017
Rated Good; inspectors found safe, kind and well-managed care, with activities and dementia-friendly signs still needing attention.
This was an unannounced inspection on 16 January 2017. Inspectors visited all areas, observed care and mealtimes, spoke with people living in the home, relatives, staff and health professionals, and checked care plans, medicines, staffing, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and well cared for. Inspectors found kind and respectful staff, suitable staffing on the day, safe medicines systems, staff training and effective checks on quality.
The inspectors found some areas to improve. Activities did not always meet people's needs, and some people said they were bored. Signage to help people living with dementia find their way around was limited. One care review was overdue, and the manager was asked to improve information about powers of attorney in care plans.
Safe medicines
Inspectors found that medicines were stored, administered and recorded safely. Stock checks, audits and temperature checks were also in place.
“We found that medicines were being safely administered and records were kept of the quantity of medicines kept in the home.” from the report
Staff training and support
Staff had induction, ongoing training, supervision and appraisals. Training covered areas such as safeguarding, medicines, moving and handling and dementia care.
“There was a programme of staff training and supervision in place to support staff development.” from the report
Good health and nutrition support
People had meal choices and their nutritional needs were monitored. Referrals to dieticians, speech and language therapists and other professionals were made when needed.
“People had a choice of food at mealtimes and had a choice of meals, drinks and snacks.” from the report
Improving management
The inspection found that improvements made since the previous inspection had been maintained. Quality checks were being used to identify and act on problems.
“We found that improvements made had been maintained and that the service was being developed and improved.” from the report
Limited activities
needs fixingSome people said there was not much to do and that they felt bored. The activities programme was being reviewed and new activities staff had been recruited.
“Others told us, "We would like something to do sometimes, we just have to sit" and "Nothing to do though, I get bored out of my mind".” from the report
Care review was overdue
minorOne person's monthly care review had not been completed on time. The manager was asked to follow this up.
“We noted in one person's care plan that the monthly care review was overdue, as it had not been done the previous month.” from the report
Emergency staffing arrangements
needs fixingExtra staff could be called in if needed, but this arrangement was not formal. Night staffing was being reviewed as the number of people living in the home increased.
“However, this arrangement for additional assistance was not a formal system.” from the report
- 01What activities are now available across the week, and how are they matched to each person's interests and abilities?
- 02What changes have been made to signage and bedroom doors to help people living with dementia find their way around independently?
- 03How do you make sure every person's care review is completed on time?
- 04How are emergency staffing arrangements managed, particularly at night if someone with high needs has to be moved?
- 05How is information about powers of attorney recorded so all relevant staff know who to contact?
This was an unannounced comprehensive inspection covering all five key questions and included observations, discussions with people and staff, and checks of care, medicines, staffing and management records. This explanation was written from the published report of 28 March 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Highfield House
4 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2015InadequateSafe: Requires improvementEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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